Family Science
Permanent URI for this communityhttp://hdl.handle.net/1903/2239
Formerly known as the Department of Family Studies.
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Item LGBTQ+ Youth Therapeutic Engagement and Experiences: Associations with LGBTQ+ Family Environment(2024) Zheng, Azure; Fish, Jessica N,; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)LGBTQ+ youth experience unique stressors that increase the risk for poor mental health. LGBTQ+ youth’s family environment, often measured as parental acceptance and rejection of youth’s LGBTQ+ status, is associated with youth mental health; less often studied is how the family environment may be linked to LGBTQ+ youth’s access to therapy and, more importantly, experiences with LGBTQ+ affirmative and competent providers. Using a contemporary non-probability national sample of LGBTQ+ youth ages 13-17, our study examined the association among LGBTQ+ youth’s reports of caregiver supportive and rejection behaviors related to their LGBTQ+ identity and youth’s engagement and experiences in therapy. Using a step-wise logistic regression method, results tell a clear story. There is a consistent positive association between parent’s LGBTQ+ support behaviors and (1) youth access to therapy and (2) their therapists' LGBTQ+ competency. In the absence of controls, we found that parents’ rejecting behaviors were also positively associated with the youth’s access to therapy, but this relationship was mediated by the youth’s depression and anxiety symptoms. For youth who did not access therapy in the last year, those who reported more parental support were inversely related, and parental rejection positively related to wanting therapy but not receiving it. Youth who reported more rejecting behaviors from parents were less likely to perceive their therapists as LGBTQ+ competent. Findings point to varied pathways and experiences in therapy engagement for LGBTQ+ youth based on parents' support of their LGBTQ+ identity.Item Mental health among black lesbian, gay, and bisexual people: Examining patterns of risk, treatment utilization, and mental health management strategies(2023) Williams, Natasha Diamond; Fish, Jessica N; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Empirically, a Black-White “double paradox” exists whereby 1) despite living in a society plagued by anti-Black racism, Black individuals in the United States are no more likely to experience depression than their White counterparts and 2) Black individuals are more likely to report severe psychological distress, a construct that is correlated with depression. Further, intersectional theory suggests that Black lesbian, gay, and bisexual, transgender, and queer (LGBTQ+) young adults may experience elevated risk for mental health issues due to overlapping systems of oppression (i.e., racism, heterosexism). Lastly, Black LGBTQ+ persons’ utilization of professional mental health services (PMHS; e.g. therapy, medication) may be impacted by these same forces, but quantitative research has yet to explore utilization disparities at this intersection. Therefore, Studies 1 & 2 of this investigation documented disparities in major depressive episodes (MDE) and severe psychological distress (SPD), as well as differences in the utilization of outpatient PMHS. Study 3 involved semi-structured interviews with Black LGBTQ+ young adults that explored participants’ (i) experiences of intersectional minority stress; (ii) perceptions of the relationship between these experiences and their mental health; and (iii) strategies for managing their mental health. In Study 1 covariate-adjusted models, compared to White heterosexual individuals, Black LGB males and females evidenced similar or reduced odds of an MDE; there were no statistical differences between these groups for SPD. Compared to their White LGB peers, Black LGB males and females were less likely to report an MDE or SPD. However, compared to their Black heterosexual counterparts, Black LGB males and females had higher odds of an MDE and SPD. Bisexual identity (as opposed to lesbian/gay identity), age, and education were associated with MDE or SPD among the subsample of Black LGB adults. In Study 2 unadjusted models, compared to White heterosexual females, Black LGB females were less likely to use PMHS. This relationship was not significant in models adjusted for covariates. In models that accounted for mental health need, Black LGB females were less likely to use PMHS than White heterosexual females in unadjusted and adjusted models. The association for Black LGB males, relative to White heterosexual males, was not significant in unadjusted or adjusted models, regardless of mental health need. Still, predicted probabilities illustrated disparities among Black LGB adults, with and without accounting for mental health need, in PMHS utilization relative to White LGB adults and Black heterosexual adults. Age, income, and education were also associated with PMHS utilization among Black LGB individuals. Participants in Study 3 generally did not describe their identities or attribute their bias experiences in intersectional terms. Rather, most described themselves as “Black first” and discussed instances of anti-Black or, separately, anti-queer discrimination. Almost all shared periods of poor mental health and discussed myriad strategies for managing their mental health, including seeking PMHS, as well as social supports and self-care strategies. Together, these studies illustrate differences in risk for depression and psychological distress, disparities in utilization of PMHS, and mental health experiences of Black [LGB]TQ+ young people. Based on all three studies, it appears that the experience of being a sexual minority in Black contexts may have different, and potentially more deleterious, mental health consequences than being Black in queer contexts. In aggregate, this investigation’s findings have implications for health policy and mental health practice related to bias/discrimination, barriers to care, and PMHS quality. Directions for future research are also discussed.Item EXAMINING THE ASSOCIATION BETWEEN INTERPREGNANCY INTERVAL AND MATERNAL HEALTH IN THE POSTPARTUM PERIOD(2023) Barber, Gabriela A; Thoma, Marie E; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Interpregnancy interval (IPI) is defined as the period of time between a previous birth and a subsequent conception, usually measured in months. While recommendations issued by the World Health Organization and the American College of Obstetricians and Gynecologists provide guidance for ideal birth spacing, many births occur after non-optimal IPIs – either too short (<18 months) or too long (60+ months). These recommendations were motivated by the body of research on a host of adverse infant and maternal health outcomes associated with non-optimal IPIs. To date, the literature has focused heavily on the association between IPI and adverse infant health outcomes, with limited attention in comparison being given to IPI and maternal health. Within the research on IPI and maternal health, there is a narrow focus on physical health outcomes related to pregnancy/delivery complications, with few studies looking at health outcomes in the postpartum and beyond. In order to fill this gap, this research investigated the association between IPI and several postpartum maternal health outcomes/indicators, including 1) postpartum depression (PPD), 2) attendance at a postpartum checkup, and 3) postpartum contraceptive use (any and type). One of the perennial difficulties in studying IPI is parsing out whether IPI has an independent association with a health outcome or behavior or is exerting its effects through pregnancy intention, therefore, for each aim, pregnancy intention was tested as a moderator. For each aim, unique cut-offs for IPI were determined after examination of the association between more detailed IPI categories and the outcome of interest. Categories were collapsed into broader IPI classifications when the associations were similar in order to maximize precision of the estimates and in order to allow us to characterize the most clinically relevant exposure for specific health outcomes. In fully adjusted models, individuals who had IPIs less than 18 months were significantly more likely to experience elevated PPD symptoms (aOR: 1.19, 95% CI: 1.02 – 1.39, p=0.024) when compared to individuals with long IPIs, and individuals who had IPIs less than 12 months were significantly less likely to attend their postpartum checkup (aOR: 0.78, 95% CI: 0.66 – 0.93, p=0.006) when compared to those with long IPIs. Pregnancy intention was not found to significantly moderate either of these associations. For the third aim, pregnancy intention was found to moderate the association between IPI and any use of postpartum contraception. Stratified analyses show that it is among unintended pregnancies that there is an association between short IPI and increased use of any contraception in the postpartum. Among unintended pregnancies, those with IPIs less than 6 months (aOR: 2.31, 95% CI: 1.37 – 3.90, p=0.002) and those with IPIs of 6-11 months (aOR: 2.15, 95% CI: 1.48 – 3.10, p=0.001) were more likely to be using any contraception in the postpartum than those with long IPIs, and the magnitude of this association exceeded that of other IPI intervals and pregnancy intention categories. Among those who were using contraception in the postpartum, individuals with IPIs less than 6 months were more likely to be using highly-effective methods (aOR: 1.59, 95% CI: 1.22 – 2.10, p=0.001) than least-effective methods of contraception. Pregnancy intention did not significantly moderate the association between IPI and type of contraception. Future research should continue to explore the association between IPI and a broader range of maternal health outcomes and work to identify the mechanisms through which IPI may be impacting these outcomes. Recent changes in reproductive policies in the U.S. may also soon change the proportion of individuals who experience short IPIs, therefore making it even more important to understand how this shift may impact a broad range of maternal health behaviors and outcomes. This research highlights how an increase in births occurring after a short IPI would likely increase rates of PPD and increase demand for certain family planning services.Item THE STATE OF GRADUATE STUDENT MENTAL HEALTH IN THE UNITED STATES: ELEVEN YEARS AND 200,000 STUDENTS(2020) DeYoung, Kathryn Alyce; Leslie, Leigh A; Shackman, Alexander J; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Graduate students are an essential part of the academic enterprise. Converging lines of evidence suggests that many graduate students experience high levels of emotional distress. Yet the true depth and breadth of this public health “crisis” has remained unclear. The present study used survey data collected from 187,427 American graduate students between 2008 and 2019 as part of the ACHA-NCHA II to demonstrate that moderate-to-severe emotional distress, psychiatric illness, and suicidality are common among graduate students. Remarkably nearly 1 in 3 students were diagnosed with or treated for one or more psychiatric disorders. Notably, every indicator of emotional distress and illness increased over the past decade, in some cases substantially, above and beyond contemporaneous shifts in demographic and institutional characteristics. This study represents the most comprehensive assessment to date, provides crucial information for refining research and policy, and sets the stage for efforts aimed at developing effective intervention strategies.Item RACE AND IMMIGRATION STATUS AS MODERATORS OF THE RELATIONSHIP BETWEEN FAMILY ACCEPTANCE/FAMILY REJECTION AND DEPRESSIVE SYMPTOMS FOR LGBTQ+ YOUTH(2019) Levin, Emma R; Leslie, Leigh; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research consistently demonstrates that LGBTQ+ youth, when compared to non-LGBTQ+ youth, are at significantly greater risk for depression, anxiety, substance use, and suicidality as a result of stressors related to belonging to a minority group (Russell & Fish, 2016). Family acceptance is an important protective factor against these negative mental health outcomes, and family rejection has been demonstrated as an important risk factor. Research on LGBTQ+ youth has been criticized for regarding all LGBTQ+ youth as the same and not accounting for the intersection and interaction with other identities such as race or immigrant status. The research questions posed by this study are 1) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family acceptance and depressive symptoms?, and 2) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family rejection and depressive symptoms? Results of the present study show that race significantly moderated the relationship between family acceptance and depression for LGBTQ+ youth, but did not moderate the relationship between family rejection and depression. Immigrant status moderated neither relationship. Three-way interactions with race and immigrant status moderated both the association among family acceptance, family rejection, and depression. Clinical implications and implications for future research are discussed.Item SELF-COMPASSION AMONG WOMEN WITH ABUSE EXPERIENCES: THE ROLE OF SOCIAL SUPPORT(2018) LeVine, Naomi; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Intimate partner violence (IPV) is a widespread issue that affects the physical and mental health of its survivors. Because of the severity of the outcomes, it is important that clinicians understand potential risk and protective factors in regard to providing the best outcomes for their clients. Under the framework of the stress-buffering hypothesis, this study explored the association between IPV and a woman’s self-compassion, as well as the role of social support as a variable moderating that association. It was hypothesized that higher levels of IPV victimization would be associated with lower levels of self-compassion among women with experiences of IPV. In addition, social support was hypothesized to weaken the association between IPV and individuals’ self-compassion. Data collected from a sample of women in abusive relationships (n=61) was analyzed using linear regression and a test for moderation. Results indicated that there was no significant association between IPV victimization and self-compassion. However, the interaction between IPV and social support tended toward significance. Contrary to the second hypothesis, among women with higher levels of social support, greater IPV was associated with lower self-compassion. Implications for clinical practice when working with this population are discussed.Item EXPLORING THE EXPERIENCES OF WOMEN WITH ANOREXIA NERVOSA IN COMMITTED ROMANTIC RELATIONSHIPS: A QUALITATIVE STUDY(2018) Krenz, Natalie; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Eating disorders (EDs) significantly affect an individual’s quality of life and have the highest mortality rate of all psychological disorders. Therefore, understanding EDs is imperative for researchers and treatment professionals. EDs have a systemic impact; however, previous research largely focused only on impacts with adolescents and their families. The present study fills a gap in research on how Anorexia Nervosa (AN) influences adults within their romantic relationships. Qualitative data analysis was conducted by interviewing 9 adult women who ranged in age from 21 to 32, had been diagnosed with AN, and were in committed relationships for at least 6 months during some point in their recovery. Using grounded theory, their perceptions of how their ED symptoms and recovery interact with the functioning of their relationships were investigated. The results provide insight on the interaction between AN and romantic relationships and can aid in development of more effective couple therapy for individuals with AN.Item THE RELATIONSHIP BETWEEN PSYCHOLOGICAL AGGRESSION VICTIMIZATION AND WOMEN’S ANXIETY: ALCOHOL USE AS A MODERATOR(2018) Mauss, Jasmine Marie; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Intimate partner aggression is a serious concern, creating problematic issues among individuals and couples in romantic relationships. Psychological aggression, specifically, has shown to have detrimental effects on physical and mental health. Victims of such abuse often times find different ways to cope with the negative feelings that accompany being a recipient of partner aggression. The present study examines psychological aggression in relationships and its resulting associations with female partner anxiety symptoms. Further, the study explores alcohol use as a possible coping strategy and the way this tactic moderates the relationship between partner aggression and anxiety. Results from the study show that there was no significant association between partner aggression and anxiety symptoms and that alcohol use did not act as a moderator for this association. However, it was found that for two subtypes of psychological aggression (domination/intimidation and denigration) there were negative associations between aggression victimization and anxiety. Unlike the other subscales of psychological aggression (hostile withdrawal and restrictive engulfment), which showed no significance, higher levels of domination/intimidation, restrictive engulfment, and denigration were associated with lower levels of anxiety. Implications of the findings for future research and clinical practice are discussed.Item Adaptive Coping in African American Adolescents: The Role of Mother-Adolescent Relationship Quality, Parental Monitoring, and Racial Socialization(2018) Greene, Diamond; Smith-Bynum, Mia A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Adolescence can be a stressful stage of development for adolescents and their families; however, it is particularly stressful for African American adolescents who also have to deal with additional stressors such as racial discrimination, which can be detrimental to one’s mental health. The purpose of this study is to examine how: (a) adolescents’ perception of mother-adolescent relationship quality, (b) adolescents’ perception of parental monitoring from their parents, and (c) adolescents’ perception of racial socialization (e.g., cultural coping with antagonism) messages, predicts adaptive coping strategies. The sample included 111 African American adolescents (55% female), ranging from ages 14 to 17 (mean age = 15.50), residing in the Washington, DC metropolitan area between 2010 and 2011. The median household income for this sample is $60,000-69,999. Results showed that adolescents’ perception of positive mother-adolescent relationship quality and receiving racial socialization messages, specifically cultural coping with antagonism messages, were significant predictors of adaptive coping.Item "Triggered": How the exposure to or experiences with Police are affecting Black Women's psychological functioning(2018) Madison, Jordan Ashley; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Interactions between the Black community and the police have gained national attention recently. There is emerging literature on how being a victim and/or being exposed to these deaths and other incidents of police brutality is affecting the Black community. This study used qualitative interviews to explore the relationship between the exposure to and interactions with police and Black women’s psychological functioning and to further the understanding of coping strategies being used by Black women (n=5) to deal with this stressor. Results indicated that Black women feel fear, hyper-vigilance, and the randomness of negative interactions with the police. They reported using prayer, activism, and avoidance as ways to cope and discussed needing therapists to normalize therapy, as well as acknowledge and understand their experiences. Findings have the potential to address a significant gap in literature and can inform the development of trauma-informed programs for Black women.